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Individual

BRIAN WIENK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, SCD

Contact information

Practice address
3320 S SYCAMORE AVE, SUITE 150, SIOUX FALLS, SD 57110-4532
(605) 231-5590
(605) 231-5589
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-1980
(630) 590-4329

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0639
SD
2251X0800X
Orthopedic Physical Therapist
0639
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1316195209
WELLMARK BCBS/TRICARE
01
9296204
DAKOTACARE
Enumeration date
09/04/2008
Last updated
10/05/2016
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